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THE CYCLE OF GRIEF LOSS with the life changes brought about by the loss. For example, someone who has lost a loved one might still need to care for young children in the family, so will set aside her or his own feelings in order to attend to the needs of others. This person may also take a break from the intensity of emotion through other self-care measures that can include nutrition, rest, exercise, massage, and/or social interaction. DISORGANIZATION This image represents the possible range of reactions an individual might experience with grief: from initial reactions to loss, through disorganization and eventual reorganization, to integrating the loss, and adapting to change. other kinds of loss. For example, grief can be experienced when someone is diagnosed with a life-threatening and/ or debilitating disease. The physical and psychosocial issues involved with aging and illness also contribute to the complexity of the bereavement process for many individuals. More recent advances in the understanding of grief theory include the dual-process model developed by Margaret Stroebe and Henk Schut.5 While previous models focused on stages and phases of grieving, the dual-process model recognizes a dynamic in which the bereaved individual alternates between focusing on the loss—with all the associated reactions and responses—and avoiding focusing on the loss in order to cope with the stresses and practical requirements of everyday life. In the dual-process model, it is recognized that both expressing and controlling emotion have value for the individual who is dealing with loss. The bereaved person is able to "take time off" from the intensity of emotional response to the loss in order to deal THE CYCLE OF GRIEF How individuals respond to loss depends on many factors, including their personal belief systems, their social and cultural conditioning, and the personal coping skills and support systems they have in place at the time of the loss. While people experience grief in many individual ways, there are general patterns of physical and emotional responses that frequently occur after a loss. The Cycle of Grief, at left, is a useful image for individuals to understand their own responses to loss. For massage therapists and those supporting people in times of bereavement, it is also a helpful way to understand the psychosocial experiences of their clients, as they move from the initial reactions to loss through a myriad of possible reactions and emotions, toward a healthy adaptation to change. SHOCK AND PROTEST The first phase following a loss is characterized by shock and protest. In the initial hours, days, or weeks following a loss, the individual may experience numbness or actively protest the reality of the loss. Some people may Boost your practice with ABMP's Website Builder—free for members on ABMP.com 63 LIFE FUNCTION SHOCK AND PROTEST REORGANIZATION